Alkylating Agents-cycle Non Specific

Question 1

How does alkylating agent work?

Answer 1

Interferes with DNA bases. Prevents DNA replication and RNA transcription.

Question 2

BendaMustine (treanda)

Answer 2

IV

Indications: b-Cell lymphoma, CLL, mantle cell lymphoma

Side effects: myelosuppression, n, v, fatigue, infusion reaction, tumor lysis syndrome

Question 3

Common symtpoms of all alkylating agents

Answer 3

Myelosuppression, nausea, vomiting (M,N,V)

Question 4

Busulfan (myleran, busulfex)

Answer 4

PO, IV

CML, HCT prep

Side effects: M,N,V, diarrhea, mucositis, hepatic tox, adrenal insufficiency, pulmonary symptoms

Interactions: take on empty stomach, avoid aspirin

Question 5

Carboplatin (paraplatin)

Answer 5

IV

endometrial, ovarian, HN, lung, bladder, germ cell

Side effects: M,N,V, renal toxicity, hypersensitivity reaction, alopecia, p. neuropathy

Question 6

Carmustine (BCNU)

Answer 6

IV

brain, glioblastoma, HD, NHL, MM

Side effects: M,N,V, hepatic tox, renal tox, pulm tox

Question 7

Chlorambucil (leukeran)

Answer 7

PO

CLL, HD, NHL

Side effects: M,N,V, hyperuricemia, pulm tox, skin rash

Interactions: take on empty stomach. Barbiturates increase tox

Question 8

Cisplatin (platinol)-

Answer 8

IV

esophageal, HN, Lung, ovarian, cervical, prostate, testicular, bladder, NHL

Side effects: M,N,V, metallic taste, SIADH, renal tox, ototoxicity, hypomagnesmia, infusion react, p. neuropathy

Interactions: rigorous hydration, monitor renal function and magnesium levels

Question 9

cyclophosphamide (cytoxan)-

Answer 9

IV, PO, IP

breast, ovarian, CLL, NHL, HD, MM, mycosis fungoids, wilms’, neuroblastoma, sarcoma

Side effects: M,N,V, bladder tox, cardiac tox, SIADH, alopecia

Interactions: rigorous hydration, given with mesna to prevent hemorrhagic cystitis, increases effects of anticoagulants

Question 10

Dacarbazine (DTIC)

Answer 10

IV

melanoma, sarcoma, HD, neuroblastoma

Side effects: M,N,V, flu-like symptoms, CNS toxicity (think neuroblastoma), photosensitivity (light-skin cancers)

Question 10

Ifosfamide (Ifex)

Answer 10

IV

HN, Lung, bladder, cervical, germ cell, sarcoma, HD, NHL

Side effects: M,N,V, bladder toxicity (need mesna), neurotoxicity, SIADH, alopecia

Question 11

Mechlorethamine (nitrogen mustard)

Answer 11

IV

CLL, CML, HD, NHL, mycosis fungoids

Side effects: M,N,V, hyperuricemia, pain at injection side, alopecia

Question 12

Thiotepa (thioplex)

Answer 12

IV, IM, IT, SC

breast, ovariam, bladder, sarcoma, HD, NHL

M,N,V, mucositis, renal tox, skin changes

Question 13

Temozolomide (temodar)

Answer 13

PO

astrocytoma, glioblastoma

side effects: M,N,V, fatigue, headache, hepatic tox, photosensitivity, rash

interactions: take on empty stomach with full glass of water. Do not crush or dissolve drug

Question 14

Melphalan (Alkeran)

Answer 14

IV, PO

breast, ovarian, MM, HCT, polycythemia vera

Side effect: M,N,V, mucositis, diarrhea, infusion reaction

Interactions: take on empty stomach, need anti-emetic and SF meals

Question 15

Oxaliplatin (Eloxatin)

Answer 15

IV

colorectal, pancreatic, gastroesophageal

Side effects: M,N,V, diarrhea, neurotoxicity, hepatic tox, allergic reaction

Interactions: avoid cold foods, B6 to prevent hand-and-foot